If a patient with low metastatic burden has bulky retroperitoneal adenopathy without osseous metastasis, would you recommend prostatic radiation?

Given CHAARTED and STAMPEDE, what would you recommend? Would lymph node vs osseous mets change your recommendation given the trial did allow patients with metastatic adenopathy?

Answer from: Radiation Oncologist at Academic Institution

We could debate whether "bulky" retroperitoneal adenopathy is a truly low volume metastatic disease, but technically it would fit the definition used in the STAMPEDE Trial. In addition, patients presenting with nodal metastatic disease may have a more indolent course than those presenting de novo wi...

Comments

Radiation Oncologist at Washington University School of Medicine
I agree with @Mitchell S. Anscher's thoughtful com...

Radiation Oncologist at Beth Israel Deaconess Medical Center/Harvard Medical School
Agree. We all look to the Stampede trial to suppor...

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If a patient with low metastatic burden has bulky retroperitoneal adenopathy without osseous metastasis, would you recommend prostatic radiation?

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